Aim: The aim of this study is to assess the efficacy of the serum lactate/albumin (L/A) ratio as a prognostic marker of sepsis syndrome. Materials and methods: This study was conducted in the Internal Medicine Department at Acharya Vinoba Bhave Rural Hospital with a sample size of 160 cases of sepsis. The serum L/A ratio was calculated on admission and correlated with deaths and morbidity. Statistical analysis was significant if the P-value was less than 0.05. Results: The mean age of patients was 52.83 ± 16.80 years with a male predominance (64.4% vs. 35.6%). The mean L/A ratio was 0.95 ± 0.46. The proportion of discharged subjects and mortality were 58.8% and 41.2%, respectively. The study found that a higher mean L/A ratio (1.1-1.44) was significantly linked to the various variables in the study. Furthermore, a significantly higher median L/A ratio of 1.23 was found in subjects with vasopressor use. The median L/A ratio in the Discharge group and Death group was 0.64 and 1.27, respectively. The area under the receiver operating characteristic (AUROC) curve indicated that accurate diagnostic performance was 0.976 in predicting Death versus Discharge for the L/A ratio. Conclusion: This study found that, compared to lactate and albumin alone, the predictor value of the L/A ratio was outstanding in predicting death and hospital stay (discharge) among sepsis participants, with a sensitivity of 100% and a specificity of 88%.

Obesity, specifically abdominal obesity, is a major risk factor for diabetes. A strong association has been marked between diabetes and obesity. Many abdominal obesity indices have been established, including waist circumference (WC), BMI, and a new tool, the visceral adiposity index (VAI). However, very limited research highlights the association of these anthropometric parameters and VAI to the various microvascular complications of diabetes mellitus (DM). The objective of this study is to investigate the association of VAI with microvascular complications such as retinopathy, nephropathy, and neuropathy in type 2 DM (T2DM) patients. Data from Acharya Vinoba Bhave Rural Hospital (AVBRH) was analyzed in this case-control study with a sample size of 250 patients consisting of 125 cases and 125 controls. The cases and controls were age- and gender-matched. BMI and WC were measured in these patients, and the VAI was calculated. These anthropometric parameters were then analyzed to estimate their correlation with the microvascular complications of T2DM. The mean age of cases in this study was 58.37 ± 12.08 years and that of controls was 57.61 ± 14.51 years. Anthropometric parameters, namely, BMI, WC, and VAI were raised in cases as compared with controls, and they showed significant statistical relation with diabetes (for BMI, P = 0.003; for WC, P = 0.001 for males and P = 0.002 for females; and for VAI, P = 0.005). A significant correlation was noted in the high-density lipoprotein (HDL) cholesterol (P = 0.017 for males and P = 0.0004 for females) and triglyceride (TG) levels (P < 0.0001) between cases and controls. On distributing the male and female cases in quartiles, it was observed that with increasing quartiles, VAI increased significantly and was associated with an increased risk of microvascular complications such as retinopathy, nephropathy, and neuropathy. When the anthropometric parameters and VAI were compared with the total microvascular complications and the receiver operating characteristic curve studied, VAI had the maximum AUC (AUC for VAI was 0.826, WC was 0.813, and BMI was 0.806). Univariate analysis of the various microvascular complications showed that WC, BMI, HDL, TGs, and glycated hemoglobin (HbA1c) were all significantly correlated to the microvascular complications in T2DM patients. As the VAI was significantly raised in T2DM patients and also seen to be significantly associated with microvascular complications, it could be used as a screening tool for T2DM patients.

Stings by bees or wasps are frequent worldwide. From minor urticaria to severe anaphylaxis, allergic symptoms are typically present. Various reports of unexpected reactions to bee stings affecting the neurological, renal, cardiac, pulmonary, and ocular systems have been published. Here, we present a rare instance of subacute bee sting syndrome that resulted in an ischemic stroke over a 24-hour period.

Anaemia (particularly iron deficiency) is of important concern in patients with chronic kidney disease (CKD) as it reflects the outcome of the disease. Current recommendations for the use of intravenous iron (IV) therapy in the management of anaemia in such patients are limited. This study highlights the comparison of oral to intravenous iron in patients with chronic kidney disease. This is a prospective case-control study comparing intravenous iron to oral iron in chronic kidney disease patients admitted to the Medicine Department of Acharya Vinoba Bhave Rural Hospital, in central India from October 2018 to October 2020. A total of 150 patients were divided into two groups of 75 each, one receiving oral iron (ferrous sulfate 325 mg tablets) and the other intravenous iron (IV iron sucrose). Serum iron, serum ferritin, and transferrin saturation (TS) showed increased levels in the IV iron group than in the oral iron group. In the IV group, a statistically significant increase was found in haemoglobin levels after therapy among all stages of kidney disease (p<0.05) while the same was not reported in the oral iron group. IV iron sucrose therapy had been found to be effective, well-tolerated, and more successful than oral iron treatment in chronic kidney disease patients as far as the parameter of iron deficiency anaemia is concerned.

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a complication developed in patients due to vaccination. High-risk factors like a prothrombotic state predispose such a condition. Due to the increase in vaccinations after the coronavirus 2019 (COVID-19) pandemic, the predisposition to risk factors has increased. Hence, complications occur at a very young age. This case report is of a young male who developed venous sinus thrombosis post the COVID-19 vaccination and was diagnosed and treated promptly.

Intermediate syndrome affects 10-40% of those with severe organophosphorus poisoning, causing delayed weakness in the proximal parts of the body, neck flexors, and breathing muscles. We present the case of organophosphorus poisoning that advanced to intermediate syndrome and subsequently worsened, with imaging later revealing the Marchiafava-Bignami condition, which aggravated the intermediate syndrome.